Litigation Trends in Vascular Surgery in the UK: A Retrospective Analysis of NHS Resolution Data and Impact of the COVID-19 Pandemic.

BACKGROUND

Vascular surgery (VS) is a high-risk specialty, with complex procedures and multimorbid patients. Medicolegal claims offer insight into recurring clinical vulnerabilities. We aimed to analyze litigation trends in VS over the past decade in England and the potential impact of the COVID-19 pandemic.

METHODS

A retrospective review of VS-related claims submitted to NHS Resolution between 2014/15 and 2023/24 was conducted following a Freedom of Information request. The trends in claim volumes, alleged causes, injuries, and costs were analyzed.

RESULTS

A total of 1,288 claims were reviewed; 814 resulted in damages costing £205 million. The most common causes for claims were failure/delay in treatment (427 claims; 36.6%), failure/delay in diagnosis (138 claims; 10.7%), and inappropriate treatment (84 claims; 6.5%). Lower limb amputation was the most frequent injury (436 claims; 33.8%), followed by fatality (174 claims; 13.5%). Litigation costs rose in the post-COVID-19 pandemic years (2019-24) compared to prepandemic (2014-19) by 30.8% (£88 to £116 million), with a 33% and 50% increase in claims related to delays in diagnosis (59-79) and delays in performing operations (20 to 30), respectively. Average cost per closed claim was £239,680 in 2014/15, peaking at £386,038 in 2021/22 and closing at £174,922 in 2023/24.

CONCLUSION

Treatment delays and amputations account for the majority of VS claims. The COVID-19 pandemic exacerbated pre-existing systemic pressures, contributing to rising costs. Targeted efforts to improve time to treatment, documentation, and communication are essential to reducing litigations. Ongoing review of litigation data could help inform policy and enhance outcomes.